tbuckley/cabot-search huggingface dataset:
AB0837 NEUROPATHIC PAIN COMPONENT AND ITS RELATIONSHIP WITH QUALITY OF LIFE IN PATIENTS WITH ANKYLOSING SPONDYLITIS
Authors: I. Kedyk, M. Stanislavchuk
Journal: Annals of the Rheumatic Diseases (2022)

Background Ankylosing spondylitis (AS) is a chronic systemic inflammatory disease of the connective tissue 1 . AS often affects men aged 20-40 years and characterized by a progressive affect with rapid loss of work ability, deteriorating quality of life and reducing its duration. Quality of life is one of the markers of disease progression and evaluation of the treatment efficacy. The leading clinical symptom of AS is chronic pain, which may have not only nociceptive but also neuropathic component, which is not taken into account in the treatment of this category of patients, while pain is one of the main factors in reducing quality of life. Objectives To investigate the prevalence of the neuropathic pain component (NPC) and its relationship with the quality of life in patients with AS. Methods AS patients was diagnosed according to the New York 1984 classification criteria. The NPC was assessed by the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) and The Douleur Neuropathique 4 (DN4). Quality of life was assessed by the Ankylosing Spondylitis Quality of Life (ASQoL). We examined 142 patients with AS (79.5% of men) in the rheumatology center from 2016 to 2021. The mean age was (M±SD) 41.9 ± 9.7 years, the disease duration was 5.7 ± 4.6. Statistical analysis performed by the Microsoft Excel and IBM Statistics SPSS 20. Results NPC assessed by the LANSS (≥ 12) was found in 31% of patients, by the DN4 (&gt; 4) in 38%. ASQoL in patients with AS with NPC by the LANSS was 12.27 ± 4.27, by the DN4 - 11.64 ± 4.19, which was significantly higher than in patients with AS without NPC: LANSS (7.97 ± 3.76), DN4 (7.86 ± 3.88). ASQoL had a strong direct correlation with LANSS (0.561; p &lt;0.01) and DN4 (0.478; p &lt;0.01) that means - presence of neuropathic pain substantially effects quality of life in patients with AS. Conclusion NPC is found in 31% - 38% of patients with AS. It is established that the presence of the neuropathic pain component significantly reduces the quality of life in patients with AS, which should be taken into account during the treatment. References [1]Furst, D. E., &amp; Louie, J. S. (2019). Targeting inflammatory pathways in axial spondyloarthritis. Arthritis research &amp; therapy , 21 (1), 135. https://doi.org/10.1186/s13075-019-1885-z Disclosure of Interests None declared
Hepatocellular carcinoma downstaging for liver transplantation in the era of systemic combined therapy with anti‐VEGF/TKI and immunotherapy
Authors: Nguyen H. Tran, Sergio Muñoz, Scott Thompson, Christopher L. Hallemeier, Jordi Bruix
Journal: Hepatology (2022)

Hepatocellular carcinoma remains a global health challenge affecting close to 1 million cases yearly. Liver transplantation provides the best long-term outcomes for those meeting strict criteria. Efforts have been made to expand these criteria, whereas others have attempted downstaging approaches. Although locoregional approaches to downstaging are appealing and have demonstrated efficacy, limitations and challenges exists including poor imaging modality to assess response and appropriate endpoints along the process. Recent advances in systemic treatments including immune checkpoint inhibitors alone or in combination with tyrosine kinase inhibitors have prompted the discussion regarding their role for downstaging disease prior to transplantation. Here, we provide a review of prior locoregional approaches for downstaging, new systemic agents and their role for downstaging, and finally, key and critical considerations of the assessment, endpoints, and optimal designs in clinical trials to address this key question.
AB1554-HPR DRUG-RELATED PROBLEMS EXPERIENCED BY PATIENTS WITH RHEUMATIC DISEASES: A LONGITUDINAL OBSERVATIONAL STUDY
Authors: L. Haegens, V. Huiskes, E. M. Smale, C. Bekker, B. Van den Bemt
Journal: Annals of the Rheumatic Diseases (2022)

Background Patients with rheumatic diseases can experience multiple drug-related problems (DRPs) along their patient journey. 1 Insight into patients’ experience of DRPs over time might aid in timely identifying and preventing DRPs. 2,3 Objectives To longitudinally identify DRPs experienced by patients with rheumatic diseases. Methods A prospective observational study was conducted in a Dutch outpatient pharmacy. Adult patients with rheumatic diseases that were prescribed medication by a rheumatologist were questioned about experienced DRPs by telephone 4 times in 8 weeks using a structured interview-guide. Unique DRPs (i.e. DRPs not reported in earlier interviews by individuals) were categorized using a classification for patient-reported DRPs and analysed descriptively. Results In total, 52 participants (median age 68 years (interquartile range (IQR) 62-74), 52% male) completed 192 interviews with 45 (87%) participants completing all 4 interviews. The majority of patients (65%) were diagnosed with rheumatoid arthritis. Patients reported a median number of 3 (IQR 2-5) unique DRPs during interview 1. In subsequent interviews, patients reported median numbers of 1 (IQR 0-2), 1 (IQR 0-2) and 0 (IQR 0-1) unique DRPs for interview 2 to 4 respectively. Participants reported a median number of 5 (IQR 3-9) unique DRPs over all completed interviews. Unique patient-reported DRPs were most frequently categorized into (suspected) side effects (28%), medication management (e.g. medication administering or adherence) (26%), medication concerns (e.g. concerns regarding long-term side-effects or effectiveness) (19%) and medication effectiveness (17%). Conclusion Patients with rheumatic diseases experience various DRPs over time. These patients might benefit from continuous support during their patient journey. References [1]Huiskes, V. J. B., Burger, D. M., Van Den Ende, C. H. M. &amp; Van Den Bemt, B. J. F. Effectiveness of medication review: A systematic review and meta-analysis of randomized controlled trials. BMC Fam. Pract. 18 , (2017). [2]Kari, H., Kortejärvi, H., Airaksinen, M. &amp; Laaksonen, R. Patient involvement is essential in identifying drug-related problems. Br. J. Clin. Pharmacol. 84 , 2048–2058 (2018). [3]Kwint, H. F., Faber, A., Gussekloo, J. &amp; Bouvy, M. L. The contribution of patient interviews to the identification of drug-related problems in home medication review. J. Clin. Pharm. Ther. 37 , 674–680 (2012). Acknowledgements The authors wish to thank the patients that participated in this study and the pharmacy technicians that conducted the structured interviews. Disclosure of Interests None declared
Personalized Volumetric Tissue Generation by Enhancing Multiscale Mass Transport through 3D Printed Scaffolds in Perfused Bioreactors
Authors: David P Forrestal, Mark C Allenby, Benjamin Simpson, Travis J Klein, Maria A Woodruff
Journal: Advanced Healthcare Materials (2022)

Engineered tissues provide an alternative to graft material, circumventing the use of donor tissue such as autografts or allografts and non-physiological synthetic implants. However, their lack of vasculature limits the growth of volumetric tissue more than several millimeters thick which limits their success post-implantation. Perfused bioreactors enhance nutrient mass transport inside lab-grown tissue but remain poorly customizable to support the culture of personalized implants. Here, a multiscale framework of computational fluid dynamics (CFD), additive manufacturing, and a perfusion bioreactor system are presented to engineer personalized volumetric tissue in the laboratory. First, microscale 3D printed scaffold pore geometries are designed and 3D printed to characterize media perfusion through CFD and experimental fluid testing rigs. Then, perfusion bioreactors are custom-designed to combine 3D printed scaffolds with flow-focusing inserts in patient-specific shapes as simulated using macroscale CFD. Finally, these computationally optimized bioreactor-scaffold assemblies are additively manufactured and cultured with pre-osteoblast cells for 7, 20, and 24 days to achieve tissue growth in the shape of human calcaneus bones of 13 mL volume and 1 cm thickness. This framework enables an intelligent model-based design of 3D printed scaffolds and perfusion bioreactors which enhances nutrient transport for long-term volumetric tissue growth in personalized implant shapes. The novel methods described here are readily applicable for use with different cell types, biomaterials, and scaffold microstructures to research therapeutic solutions for a wide range of tissues.
AB0985 Predictive value of ultrasound in hand osteoarthritis
Authors: S. Abdellaoui, S. Lefkir
Journal: Annals of the Rheumatic Diseases (2022)

Background Hand osteoarthritis (HOA) is a complex degenerative pathology with sometimes noisy joint manifestations that can mimic inflammatory rheumatism. The osteoarticular ultrasound, is a valuable addition to the clinical examination, remains little used for diagnosis and monitoring HOA. Objectives The objective of our study is to analyze the ultrasound characteristics of arthritic hands OA in order to know the lesions and to better correlate the clinical data with the sonographic results. Methods We performed an ultrasound study of 38 patients (76 osteoarthritis hands) suffering from finger osteoarthritis meeting the ACR criteria. SPSS.20 Software was performed to data analysis Results There were 38 patients: 84% women and 16% men, mean age was 61 years. 47.36% had had a manual profession, 39.47% had associated osteoporosis, 66% had reported the presence of finger nodules in the mother in family history. 60.52% of patients presented with Heberden’s nodules, 34.21% with Bouchard nodules, 63.15%an adductus inch and 13.15% an inch in “M” deformation. Impairment of Metacarpo-phalangeal (MP), Proximal inter-phalangeal (PIP), Distal Inter-phalangeal (DIP) and Trapeziometacarpal (TM) were found respectively: clinically in 24%, 58%, 87% and 76% of cases, and in 8%, 37%, 74% and 92% after ultrasound examination. The impairment was more severe from side of the dominant hand in 39.47% of cases clinically vs 52.63% after an ultrasound analysis. Regarding “erosive” HOA, 36.84% of patients presented at least one clinical and / or sonographic criterion suggesting an erosive form. 7.89% of patients had rigidity, 13.15% erythema, 34.21% swelling and 60.52% paresthesia. According to ultrasound, 28.94% showed an erosion / reconstruction aspect. 26.31% of the patients had presented an effusion of the PIP, 47.36% an effusion of the DIP, grade 1 Doppler signal was found in 15.78% with a strong clinical correlation and positive ultrasound signs in 65,78% of cases, no synovitis was reported. Conclusion Hand osteoarthritis is a very heterogeneous disease, the added value of ultrasound appears to be of interest in the diagnosis and monitoring patients with this pathology. References [1]Krivotulova I. et al Osteoarthritis of the hand: Clinical and ultrasound parallels. Osteoarthritis and Cartilage 29 (2021) S10-S432. [2]Mancarella L. et al. Ultrasound detected inflammation is associated with the development of new bone erosions in hand osteoarthritis: a longitudinal study over 3.9 years. Osteoarthritis and Cartilage 23 (2015) 1925-1932. [3]Mathiessen A. et al. Ultrasound detected osteophytes predict incident radiographic hand osteoarthritis and pain five years later. Osteoarthritis and Cartilage 23 (2015) A82-A416 Disclosure of Interests None declared
AB1229 FRÉQUENCE ET ÉTIOLOGIES DES LOMBOSCIATIQUES SECONDAIRES: EXPÉRIENCE D’UN SERVICE DE RHUMATOLOGIE
Authors: Z. Sfar, M. Brahem, H. Hachfi, Y. Mohamed
Journal: Annals of the Rheumatic Diseases (2022)

Background Secondary lumbosciatica (LS) is a rare clinical situation, but which must be eliminated in the event of any radiculopathy for better therapeutic management. Objectives The objective of our study was to determine the frequency and etiologies of secondary LS among patients hospitalized in the rheumatology department for exploration of lumbosciatica. Methods This is a retrospective, single-center study including patients hospitalized in the Rheumatology department of the Taher Sfar hospital in Mahdia for treatment of lumbosciatica, during the period between January 2014 and November 2021. Results We included in this study 357 patients hospitalized in our department for exploration of LS. After an etiological assessment, we retained the diagnosis of secondary LS in only 11 patients among our study population, ie 3.1% of cases. Among them, 8 patients were men (72.72%) and the other 3 were women (27.27%) with a sex ratio (M / F) of 2.66. The average age was 65 years with extremes between 55 and 88 years. The mean duration of symptomatology evolution was 6 months with extremes ranging from 15 days to 02 years. The mean pain VAS was 6.8 [2-8], and the majority (81.81% of cases) had inflammatory sciatica. 36.36% of patients (4 cases) had an L5 path, one patient had S1 irradiation and 54.54% (6 cases) had a truncated LS The general deterioration with weight loss was noted in 5 patients (45, 45% of cases) and vesico-sphincteric disorders in 2 patients (18.18%). Physical examination revealed spinal syndrome in 63.63% of cases (7 patients), radicular syndrome in 45.45% of cases (5 patients) and neurological signs of cauda equina syndrome in two patients (18, 18% of cases). Biologically, 81.81% of patients (9cas) had a biological inflammatory syndrome, 36.36% (4cas) had impaired protein electrophoresis (hypo-gamma peak) and 27.27% (3cas) had hypercalcemia. Recourse to CT or lumbar MRI made it possible to objectify tumor bone lesions in 72.72% (8 cases) of patients, of which 3 cases (37.5%) were of prostatic origin, 2 cases (18,18 %) multiple myeloma, one case of small cell carcinoma, one case of squamous cell carcinoma and one case of bladder tumor. For the other three patients (27.27% of cases), LS was caused by infectious spondylodiscitis in the lumbar stages. Conclusion As evidenced by our study, secondary sciatica is a very rare clinical situation, more encountered in the elderly with often an alteration of the general condition. But in front of its seriousness and its functional repercussions, arises the need to eliminate it systematically whatever the ground before starting the treatment. Disclosure of Interests None declared
AB0550 CLINICAL AND PROGNOSTIC SIGNIFICANCE OF ANTINUCLEAR ANTIBODIES IN PRIMARY ANTIPHOSPHOLIPID SYNDROME: FRENCH MULTICENTER RETROSPECTIVE STUDY
Authors: L. Ricard, L. Charlotte, M. Papo, A. Mekinian
Journal: Annals of the Rheumatic Diseases (2022)

Background The antiphospholipid syndrome (APS) is defined by the development of vascular thrombosis, or pregnancy morbidity in the presence of persistent antiphospholipid antibodies (APL). Antinuclear antibodies (ANA) can be detected in primary APS patients without any clinical systemic autoimmune disease. The presence of ANA antibodies could confer a specific phenotype in primary APS. Objectives To evaluate the characteristics of APS patients with antinuclear antibodies without other autoimmune disease (ANA-positive APS patients) in comparison with primary APS without ANA (ANA-negative APS) or secondary APS patients with associated systemic lupus erythematosus (SLE-APS). Methods Clinical and biologic data from 195 APS were retrospectively collected. ANA test was considered to be positive when titers were superior or egal to the 1/80 dilution. ANA-positive APS patients did not fulfilled SLE ACR/EULAR classification criteria. Results 40 patients (21%) with ANA-positive APS were included, 77 patients (39%) with primary APS without ANA autoantibodies (ANA-negative APS) and 78 patients (40%) with SLE-associated APS (SLE-APS). Patients with ANA-positive APS presented arterial thrombosis in 20 cases (51%) and venous thrombosis in f 14 cases (41%), adverse obstetrical in 19 cases (51%), non-criteria APS features were noted in 19 cases (51%). ANA-positive APS patients had more non criteria manifestations than ANA-negative APS (48% versus 25%; p=0.01). ANA-positive APS patients had more triple APL positivity and more thrombosis recurrences in comparison with ANA-negative APS patients, respectively (59% versus 18%; p&lt;0.001) and (63% versus 36%; p&lt;0.01). ANA-positive APS and SLE-APS patients had similar clinical manifestations and recurrences. Despite a limited follow-up (28 months (11-50)) none of the ANA-positive APS patients develop SLE. Antiplatelet and anticoagulant therapies were similar for the three groups. SLE-APS patients received more immunomodulatory therapies. Conclusion ANA positivity in patients with APS enables to individualize a subset of patients with a more severe phenotype. Whereas the ANA positivity does not seem to be associated with the risk to develop SLE, prospective studies with a longer follow-up are necessary, in particular to evaluate the effect of additional therapies in this subset of APS. Disclosure of Interests None declared
POS1424 RISK FACTORS FOR ADVERSE EVENTS OF SULFAMETHOXAZOLE-TRIMETHOPRIM PROPHYLAXIS IN PATIENTS WITH SYSTEMIC RHEUMATIC DISEASES
Authors: K. Hiramoto, M. Akiyama, Y. Kaneko
Journal: Annals of the Rheumatic Diseases (2022)

Background The prophylactic use of sulfamethoxazole-trimethoprim (SMX/TMP) can reduce the risk for developing pneumocystis pneumonia in immunosuppressed patients with systemic rheumatic diseases, whereas discontinuation of SMX/TMP prophylaxis is frequent due to adverse events (AEs) with this drug. Objectives The purpose of this study was to identify risk factors for AEs of SMX/TMP in patients with systemic rheumatic diseases. Methods All consecutive patients who were admitted in our hospital for induction treatment between 2012 and 2019 and newly received prophylactic SMX/TMP were included in the study. We divided them into two groups according to the presence or absence of AEs of SMX/TMP leading to discontinuation of the drug and compared clinical characteristics between the AE and non-AE groups. Multivariable analysis was performed to identify risk factors for AEs of SMX/TMP prophylaxis. Results A total of 438 patients were included in the study. Rheumatic diseases of the patients were systemic lupus erythematosus (25.3%), anti-neutrophil cytoplasmic antibody associated vasculitis (15.5%), rheumatoid arthritis (11.6%), polymyositis/dermatomyositis (10.7%), IgG4-related disease (8.5%), large vessel vasculitis (7.1%), adult-onset Still’s disease (AOSD; 4.1%), and others (17.2%). Among them, 82 patients (18.7%) stopped SMX/TMP due to AEs. Most frequent AEs were skin rash (36.6%), followed by liver dysfunction (29.3%), thrombocytopenia (19.5%), elevation in serum creatinine levels (15.9%), hyperkalemia (14.6%), hyponatremia (11%), leukopenia (6.1%), and fever (6.1%). Baseline age (61.4±16.4 vs 56.3±16.9 years, p=0.014) and prednisolone dose for remission induction treatment (0.97 vs 0.91 mg/kg/day, p=0.03) were significantly higher in the AE group than in the non-AE group, respectively. In terms of disease type, significantly higher rates of AEs were observed in patients with AOSD than in those with the other diseases (66.7% vs 16.7%, p&lt;0.001; Figure 1). Blood tests at SMX/TMP initiation demonstrated lower lymphocyte counts (10.1 vs 10.8 x10 2 /μl, p=0.049), lower platelet counts (20.9 vs 25.8 x10 4 /μl, p=0.045), lower albumin levels (3.2 vs 3.4 g/dl, p=0.007), higher AST levels (26 vs 23 U/L, p=0.04), higher creatinine levels (0.71 vs 0.67 mg/dl, p=0.047), and higher ferritin levels (167 vs 154 ng/ml, p=0.047) in the AEs group compared with the non-AEs group, respectively. Multivariable analysis identified an older age (OR 1.03, p=0.002) and AOSD (OR 9.72, p&lt;0.001) as independent risk factors for AEs leading to SMX/TMP withdrawal (Table 1). Conclusion Old age and AOSD were associated with AEs of SMX/TMP prophylaxis in patients with systemic rheumatic diseases. Disclosure of Interests None declared
POS0887 CHORIORETINAL MICROVASCULAR INVOLVEMENT IN SYSTEMIC SCLEROSIS
Authors: P. G. Cerasuolo, G. Gambini, E. De Lorenzis, S. Fiore, L. Verardi, G. Natalello, G. Alonzi, S. Rizzo, M. A. D’agostino, S. L. Bosello
Journal: Annals of the Rheumatic Diseases (2022)

Background The optical coherence tomography angiography (OCTA) is a new non-invasive imaging technique that can detect flow and provide information about the vessel density (VD) at different layers in the eye. The ocular microvascular network has been only occasionally addressed as disease target in scleroderma (SSc) considering the relatively low prevalence of ocular symptoms in these patients. Objectives The study aims to evaluate retinal and choriocapillaris microvasculature in a group of SSc patients compared to matched controls (HC)and according to disease characteristics, capillaroscopy findings and pulmonary function tests. Methods VD was assessed through OCTA at the retinal superficial (SCP) and deep (DCP) capillary plexus, at the foveal avascular zone perimeter (FAZP) and at the choriocapillaris (CC) of 30 SSc patients compared to 30 sex- and age-matched subjects without any retinal disease. Results The SSc patients (age 57.3±10.0, female 86.7%) had diffuse cutaneous skin disease in 30.0% of the cases, an average disease duration of 10.4±7.2 yy, and anti-centromere and anti-Scl70 antibody positivity in 40.0%and in 30.0% of the cases, respectively. Compared to the HC, SSc showed an impaired VD at SCP (47.7±3.6 vs59.1±3.5%, p=0.009), DCP (50.0±6.7 vs 54.3±6.4%, p=0.015), FAZP (48.7±4.55 vs 51.0±3.55%, p=0.034) and CC(67.1±2.2 vs 68.6±1.7, p=.005). Moreover, in the SSc group, the presence of digital ulcers (46.7%),telangiectasias (43.3%) and interstitial lung disease (46.7%) was related to reduced VD at FAZP (46.8±4.1 vs50.3±4.3%, p=0.033), CC (66.1±1.4 vs 67.9±2.4%, p=0.004), and DCP (47.2±8.8 vs 51.9±4.3, p=0.004),respectively. Lastly, the average capillary density on capillaroscopy showed a positive correlation with VD at FAZP (r=0.474, p=0.008), DCP (r=0.414, p=0.023), and foveal CC (r=0.482, p=0.007) and there was also a correlation between CC and both DLco (r=0.467, p=0.009) and FVC/DLco (r=-0.436, p=0.004). Conclusion The SSc patients in our cohort showed lower ocular vessel density at different levels compared to HC. Furthermore, impaired VD at different levels of the eye correlates with the organ involvement and the degree of digital and pulmonary microvascular impairment. According to those data, the OCTA could be proposed as a biomarker tool to investigate the microvascular abnormalities in SSc. Disclosure of Interests None declared